After my first child was delivered via c-section, the idea of not attempting a vaginal birth for my next child never even crossed my mind. Vaginal birth after cesarean (VBAC) is not the norm in the United States, but I had the benefit of having a mom who'd had a VBAC and was able to share her experience and advice. In talking we found the in the 24 years between our VBAC goals, some things never change, including the things VBAC moms are tired of hearing. Because around 90 percent of women who have a c-section will do the same for subsequent pregnancies, I knew I would be setting myself up to hear those things. However, I was more than willing to put myself through potential judgment, if it meant I would be able to experience a vaginal birth.
I'll go ahead and acknowledge that, in many cases, when it comes to hearing misinformation: I get it. Most people don't know the first thing about VBACs and it leads to a lot of questions, confusion, and unnecessary concern. Yet constantly hearing the same worried questions and comments over and over again gets old, and pretty quickly. This is especially true once you've already attempted to dispel myths or assert your confidence in your decision to a particular person, but they're too mired in their own preconceived notions to bother listening.
Arguments against VBACs largely come down to concerns for the safety of the mother and child. Concerns that, while not baseless, are frequently overstated. All birth carries a degree of risk, so a VBAC is no exception and the risks involved are more or less particular to a trial of labor after a cesarean (or TOLAC and yes, know, so many acronyms but you get used to it). Medical recommendations, however, have finally begun to catch up with the fact that a vaginal birth after a c-section is not only safe but often beneficial to everyone involved. In light of these undeniable facts, here are some things a mom attempting VBAC would love to never hear again:
"Once A C-Section, Always A C-Section"
I can't hate on this too much because it's a common misconception rooted in what was once fact and good advice. You see nowadays, c-sections are generally performed using a low, transverse (horizontal) incision, and considering a fully-formed baby comes out of there that cut is tiny. Not only does this mean you can usually hide your c-section scar while wearing a bikini, but it minimizes the risk of a problem that was more common when the scars were larger and vertical: uterine rupture during labor or delivery. Unfortunately the idea that vaginal delivery after a c-section is risky has persisted among the general public and, unfortunately, many health care providers.
"Isn't That Dangerous?"
If this is said in good faith, say, by someone who is still working off old information about c-sections, OK. I guess. I mean, it's still annoying but whatever, their concerns are well-founded if misplaced. But often people say it as a question when they really mean it as a judgmental statement, and usually after you or someone else has explained to them that the risks that once existed are no longer a significant issue. It's concern trolling at its finest.
It's so funny how as soon as you mention you're planning on a VBAC everyone is a trained medical professional. On the one hand: 10 points for not being passive aggressive by posing this as a concern trolling question. On the other hand: minus 15 points for being a regular troll. If you're going to be judgmental, try having a clearer grasp on what you're talking about, because according to the American College of Gynecology and Obstetrics (a group who really knows their way around ladyparts):
Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery. ... Approximately 60-80% of appropriate candidates who attempt VBAC will be successful.
"Your Uterus Is Going To Rupture"
I'll admit: a scarred uterus has a significantly higher chance of rupturing than an unscarred one. In fact, it's 91 times more likely to rupture! Now, that information given on its own is scary and would sway most reasonable people away from even thinking about a VBAC, until you learn the infinitesimal odds of an unscarred uterus to rupturing: fewer that 1 in 10,000 births, or .007 percent.
So, even with a 91 times greater chance of things going awry, a scarred uterus has less than one percent chance of rupture during a VBAC. So, statistically, no, there will be no exploding uteri.
"Your Doctor Is Letting You Do That?"
For starters, you have options when it comes to how you give birth (even if some options take more research and planning that others) so "letting" already feels like a creepy turn of phrase.
Secondly, if I'm going for a VBAC, it would stand to reason that my doctor is on board, no? It's not like I'm going to trick my provider at the last minute. I don't even know how that would work. So, yeah, my doctor is "letting me."
"I Would Never Risk My Child Just To Have An Experience"
Translation: "You're trying to kill your baby because you're a selfish horrible woman."
Rebuttal: As I've said (you may remember) most women who have had a c-section are good candidates to attempt a VBAC and with such candidates risk of harm to either mother or child is minimal (just like with literally any other kind of birth).
"Isn't A C-Section Easier?"
Well have you had a c-section? I'm guessing not, because it can be described many ways, but "easy" is not usually one of them. It's pretty significant surgery and recovery is a pain in the ass. Especially when you throw in the fact that moms attempting a VBAC will have another child to care for in addition to her new infant. Having to recover from surgery amid all that? Definitely not so easy.
"All That Matters Is That Everyone Is Healthy"
Surely that's not all that matters, right? In fact, that's pretty much the bare minimum. Obviously that everyone is as healthy as possible at the end of the day is the most important thing, and I don't know a single VBAC mom who felt otherwise. However, feeling in charge of your body, having a provider that will work with you and respect how you feel and support you through this important milestone definitely counts for something, right?
"I Had A Repeat C-Section And My Baby Is Just Fine, Thank You Very Much"
I trust that you made the best decision for you, your baby, and your family. That's awesome! Good for you! Don't let anyone tell you otherwise. I'm not having a VBAC to "stick it to you." I'm having a VBAC because that's the best decision for me. My choice is not an indictment of yours.
"Good For You For Reclaiming Your Body After You Were Forced Into Surgery By An Evil Doctor From The Medical Industrial Complex!"
Whoa. OK. It's entirely possible that someone attempting a VBAC has had a bad experience with a doctor or a traumatizing birth and sees her VBAC as an empowering reclamation, but that's not a forgone conclusion and having someone else tell me what I'm about is off-putting and creepy. Please, don't project your ideas about what this birth means to me. If you want to encourage me, talk to me first. (If you did, you'd learn that I had a great c-section experience, actually. You'd learn that my VBAC isn't a reclamation, because I've always felt empowered in my pregnancy and in both birth decisions.)
Between finding sympathetic care providers, hospitals and birth centers, and having the added stress of a very particular birth goal, VBAC moms have a tough enough row to hoe: please, try not to make it any harder.